Lessa I
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil.
Bol Oficina Sanit Panam. 1996 Aug;121(2):111-22.
This descriptive study was done using official data on mortality from cirrhosis of the liver for the year 1989. Its objectives were: (a) to describe mortality from cirrhosis of the liver in Brazilian adults; (b) to estimate the productive years of life lost (PYLL) prematurely (between 20 and 59 years of age) from this cause; and (c) to identify any regional differences in mortality or PYLL. The crude data were adjusted by age and sex, using the 1980 population of Brazil as the standard. Calculation of PYLL was based on the formula of Romeder and McWhinnie for years of potential life lost, modified by the author to express productive years of life lost. The crude death rates were higher in the Southeast and North, and in all regions they were higher in males, the countrywide male/female ratio being 4.5. Mortality rates among males varied from 14.37 per 100,000 in the Center-West to 35.86 per 100,000 in the Southeast; for females the rates ranged from 3.49 to 8.5 per 100,000 in the Center-West and North, respectively. The mortality curves by age for men showed a decline or stabilization after age 60, except in the North. For men in that region, the curve continued to rise, and the rate reached 86.37 per 100,000 after age 70. The curves for women also rose, most markedly in the North and Northeast. The age-adjusted rates showed a reduction for women in the Southeast, while rates in the North remained higher. Mortality from cirrhosis of the liver accounted for 48.7% of deaths from disorders of the digestive system among men and 24.1% among women. Of the 138,860 PYLL from cirrhosis of the liver in 1989, 83.2% were lost among males, while the average for the country, around 15.5 years, was similar for both sexes. However, the average PYLL for men and women in the North and women in the Center-West was much higher than in the other regions. The data suggest that cirrhosis of the liver among men in all the regions, except the North, is probably attributable to alcoholism. Among males from the North, there is strong evidence that cirrhosis with a viral etiology (hepatitis B and C virus) also exists. For women, the evidence suggests that cirrhosis of viral etiology predominates.
本描述性研究利用了1989年肝脏肝硬化死亡率的官方数据。其目标为：(a)描述巴西成年人肝脏肝硬化的死亡率；(b)估计由此原因过早（20至59岁）损失的生产性寿命年数（PYLL）；以及(c)确定死亡率或PYLL的任何地区差异。原始数据以1980年巴西人口为标准按年龄和性别进行了调整。PYLL的计算基于Romeder和McWhinnie的潜在寿命损失年数公式，并由作者进行了修改以表示生产性寿命损失年数。东南部和北部的粗死亡率较高，且在所有地区男性的粗死亡率都更高，全国范围内男性/女性比例为4.5。男性的死亡率在中西部为每10万人14.37例，在东南部为每10万人35.86例；女性的死亡率在中西部和北部分别为每10万人3.49例和8.5例。男性的年龄别死亡率曲线在60岁以后呈下降或稳定趋势，但北部除外。该地区的男性死亡率曲线继续上升，70岁以后达到每10万人86.37例。女性的死亡率曲线也上升，在北部和东北部最为明显。年龄调整后的死亡率显示东南部女性的死亡率有所下降，而北部的死亡率仍然较高。肝脏肝硬化导致的死亡在男性消化系统疾病死亡中占48.7%，在女性中占24.1%。在1989年因肝脏肝硬化损失的138,860个PYLL中，83.2%是男性损失的，而全国平均约15.5年，两性相似。然而，北部男性和女性以及中西部女性的平均PYLL远高于其他地区。数据表明，除北部外，所有地区男性的肝脏肝硬化可能归因于酗酒。在北部男性中，有强有力的证据表明也存在病毒病因（乙型和丙型肝炎病毒）的肝硬化。对于女性，证据表明病毒病因的肝硬化占主导。
